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Biomedical subjects

S Garfin

Publications and source records attributed to S Garfin.

9 recordsLinked to original sources
PubMed1993

Surgically related upper cervical spine canal anatomy in children.

MRI studies of the upper spines of 121 children were evaluated to precisely define the sagittal anatomy at C1 in the pediatric population. The diameters of the spinal cord, bony canal, space available for the cord (SAC), dens+atlanto-dens interval (ADI), and "free" space were measured. The results demonstrate an accelerated growth in the C1 canal, dens + ADI, and SAC during the first four years after birth. Steel's rule of thirds was shown to roughly hold true throughout childhood. Neonates have an average SAC diameter of 12.4 mm, a value less than the 13 mm dimension commonly used to define relative stenosis in children.

Adolescent↗
PubMed1993

Cervical stability after sequential capsule resection.

A portion of the cervical facet joint must be resected to expose and decompress cervical nerve roots from a posterior approach. When posterior fusion is performed, it is common to remove the facet capsule only for the joints being fused. This study was performed to examine the effect of resection of the facet capsule alone, without disruption of the bony facet to determine what degree of facet-capsule resection leads to acute instability. Seven human cervical cadaveric spines were used in the experiment. Nondestructive biomechanical testing was performed in axial load, flexion, extension, and torsion. Each specimen was tested intact and after sequential resection of 25%, 50%, 75%, and 100% of the C5-6 facet capsules. Axial stiffness changed very little during the experiment. In torsion, the displacement increased 1% after a 25% capsule resection, 19% after a 50% resection, and 25% after a 75% or 100% resection. No gross subluxation was seen during the torsional test. In the flexion test, posterior displacement increased 4% after a 25% resection, 5% after a 50% resection, 32% after a 75% resection, and 22% after a 100% resection. There was a statistically increased displacement seen during the flexion test after 75% or 100% of capsule resection. Thus, significant hypermobility did occur during both torsion and flexion testing with greater than 50% resection of the facet capsules. Great care should be taken when exposing an unfused facet to limit facet-capsule resection to less than 50%. With resection of greater than 50% of the capsule, postoperative hypermobility can occur and may require stabilization.

Biomechanical Phenomena↗
PubMed1991

Blunt injuries to the extracranial cerebral vessels associated with spine fractures.

Injury of the extracranial carotid or vertebral artery with associated spine fractures is a rare but documented entity. In this article, four cases are examined in which patients suffered axial fractures after motor vehicle accidents and subsequently were found to have pathology in one or more of the extracranial arteries. Misdiagnosis is a common complication because symptoms from this are often attributable to closed head injury. Early detection and treatment, however, are essential. As many as 40% of the cases reported have permanent neurologic deficit. Although cerebral angiography remains the diagnostic gold standard, other modalities (eg, transcranial doppler and magnetic resonance angiography) continue to be examined. The treatment of these lesions remains controversial. A variety of surgical procedures may be applicable depending on the time between the injury and the onset of symptoms, the location of the vascular injury, and the rapidity of diagnosis. Anticoagulation therapy appears to play a large role in the management of patients with injury of the extracranial carotid or vertebral artery.

Adult↗
PubMed1984

A study of computer-assisted tomography. II. Comparison of metrizamide myelography and computed tomography in the diagnosis of herniated lumbar disc and spinal stenosis.

One hundred twenty-two patients with surgically confirmed pathology consisting of either herniated lumbar disc, spinal stenosis, or both were included in this investigation. For each of these patients, preoperative metrizamide myelography and computerized tomography were performed. Each myelogram and CT scan was read blindly so that the neuroradiologist interpreting the study had no knowledge of the patient's surgical pathology, clinical examination, nor any knowledge of the interpretation of the other preoperative test. A painstaking attempt was made to describe precisely both the exact nature of the preoperative myelogram and CT scan interpretations. The correlations between the preoperative interpretation of each test and the observed surgical findings then were analyzed statistically. Based upon this analysis, myelography was found to be more accurate than computed tomography in the diagnosis of herniated lumbar disc (83% vs. 72%). In the diagnosis of spinal stenosis, myelography was slightly more accurate than computed tomography (93% vs. 89%). Based upon the results of this study, the authors conclude that metrizamide myelography is more accurate than computed tomography in the diagnosis of both herniated lumbar disc and spinal stenosis and remains the diagnostic study of choice for these conditions. Furthermore, metrizamide myelography gives the added advantage of visualizing the thoracolumbar junction and, thus, affords the opportunity to diagnose occult spinal tumors.

False Negative Reactions↗
PubMed1981

Pitfalls in the use of the Pavlik harness for treatment of congenital dysplasia, subluxation, and dislocation of the hip.

We reviewed the records of treatment of eighteen infants with congenital dysplasia, subluxation, or dislocation of the hip who had problems with the involved hip following treatment with the Pavlik harness. The most common problem (seen in twelve patients with a dislocated hip) was failure to obtain reduction. This failure was attributed primarily to improper use of the harness by the physician. In some patients, three to five months elapsed before the physician recognized the lack of reduction. In nine patients, a Pavlik harness of poor quality and construction added to both the physician's and the patient's problems, and in six patients, poor patient compliance with the use of the harness was partially responsible for the failure. In three patients who were initially treated in the Pavlik harness, avascular necrosis of the hip subsequently developed, in two following open reduction and in one after closed reduction and cast application. The physician's indications for use and application of the harness must be appropriate. The child must be examined frequently out of the harness both clinically and roentgenographically. Failure to achieve reduction or adductor relaxation must be recognized promptly and dealt with immediately.

Hip↗
PubMedDate not supplied

Acute exertional superficial posterior compartment syndrome.

This case report of an acute exertional compartment syndrome involving predominantly the superficial posterior compartment emphasizes several important facts: (1) The subacute recurring syndromes, if left untreated, may develop into an acute syndrome. (2) The diagnostic findings separating the acute syndrome from the chronic forms are marked pain with passive stretch of the involved muscles, paresis, and sensory deficit.8,12,15, (3) In the acute form, immediate fasciotomy is mandatory and often results in full recovery. (4) All four major compartments of the leg are susceptible to chronic or acute compartment syndromes initiated by exertion. These compartments can be decompressed as necessary through a limited skin incision as recently reported.11 (5) The need for an easily obtainable and reproducible method for measuring intracompartment pressures (e.g., the wick catheter technique) is indicated.

Acute Disease↗